Management of paraproteinaemia. Issue 978 (2nd April 2007)

• Record Type: Journal Article
• Authors: Cook, Lucy; Macdonald, Donald H C
• Is Part Of: Postgraduate medical journal. Volume 83:Issue 978(2007)
• Page Start: 217
• Page End: 223
• Publication Date: 2007-04-02
• Subjects: CC, conventional chemotherapy -- CLL, chronic lymphocytic leukaemia -- C-VAMP, cyclophosphamide, vincristine, adriamycin and prednisolone -- HDT, high dose therapy -- IPI, international prognostic index -- LPL/WM, lymphoplasmacytic lymphoma/Waldenstrom macroglobulinaemia -- MGUS, monoclonal gammopathy of undetermined significance -- MP, melphalan and prednisolone -- NHL, non-Hodgkin's lymphoma -- PBSC, peripheral blood stem cell collection -- ROTI, related organ or tissue impairment -- VAD, vincristine and doxorubicin; Medicine -- Periodicals; 610
• DOI: 10.1136/pgmj.2006.054627
• Languages: English
• ISSNs: 0032-5473

Abstract

Abstract : A paraprotein is a monoclonal immunoglobulin or light chain present in the blood or urine; it is produced by a clonal population of mature B cells, most commonly plasma cells. In individuals aged >50 years the incidence of a paraprotein is 3.2%. Plasma cell disorders can be considered as a spectrum of conditions ranging from monoclonal gammopathy of undetermined significance (MGUS), through asymptomatic, to symptomatic myeloma. MGUS is defined by a low level of paraprotein <30 g/l, bone marrow plasma cells <10% and the absence of myeloma related organ or tissue damage (predominantly renal, skeletal or bone marrow impairment.) MGUS requires no therapy and the overall risk of progression to myeloma is 1% per year. Myeloma remains incurable with a median survival of 3–4 years; autologous stem cell transplant can prolong survival, if appropriate. Thalidomide in combination with dexamethasone has an emerging role in the treatment of myeloma.